Using the DMV to Inrease Organ Donation

Last summer I went to my local Department of Motor Vehicles to renew my driver’s license. When it was my turn after a half-hour wait, a woman behind the counter summoned me, muttered a greeting and began shuffling through my papers.

After a few minutes she broke the silence and asked, “Do you want to be an organ donor?”

As a surgeon specializing in liver transplants, I’ve spent more time than most people thinking about that question. But on that particular afternoon, after a long wait on hard benches in a spartan room with a dozen others gazing glassy-eyed into space, a question about death and the dispersal of body parts felt as if it had come from out of the blue. Or from the script of a bad existential play.

Unfortunately, there are significant repercussions to those decisions. More than 100,000 patients are currently on the transplant waiting list, and about 7,000 of them die each year because of the organ shortage. Even more dire is the situation of African-American patients, who have a higher incidence of diseases that can result in kidney failure. These patients make up almost a third of the waiting list but account for only about 15 percent of those who donate after death. Even though organ allocation does not take race or ethnicity into account, the chances of a “good match” are increased within groups with genetic similarities.

For six months, a group of researchers stood outside branches of the Bureau of Motor Vehicles in northeastern Ohio and stopped anyone arriving to apply for or renew a driver’s license. They then asked half of these people to watch a five-minute iPod video on organ donation before entering the office, and they asked everyone to show their new driver’s licenses when they left the building.

In the video, family members, donors, transplant recipients and people whose friends and relatives died while on the waiting list discuss their experiences. They also answer common questions about the personal impact of donation, religious views and the level of care a patient might receive once it is known that person is a potential donor. Most significant, the video also encourages viewers to begin thinking about donation, so most people who watch the video as they enter the D.M.V. will contemplate the decision while they are waiting to get their licenses.

The video resulted in an increase of more than 10 percent in consent for donation. And the increase was even greater among African-Americans; nearly 25 percent more consented to organ donation after watching the short film.

“Video is very powerful, particularly among minority communities where health care literacy is an issue,” said Dr. J. Daryl Thornton, the lead author and an assistant professor of pulmonary and critical care medicine at the MetroHealth Campus of Case Western Reserve University School of Medicine in Cleveland. “If you give people time to think and contemplate right before you ask them, you can have an impact on their decisions.”

Those who watched the video felt better informed, had fewer conflicts about the idea of donating and were less likely to want to be buried with all their organs. But there were limitations. Regardless of whether they watched the video, some people continued to believe, for example, that carrying a donor card would mean they would receive less emergency medical care in case of an auto accident.

“There are probably some deep-seated beliefs about organ donation and the health care system that a five-minute video is unlikely to change,” Dr. Thornton said.

It is still unclear whether the increased number of consents that resulted from the video will mean more available organs in the future, but Dr. Thornton and his colleagues are heartened by their findings and are continuing their research. The video is already playing as a public service announcement in some D.M.V.’s throughout the Washington State, and there are plans to try to link it to state motor vehicle Web sites for those who are renewing a license online.

“Even though the majority of people support organ donation, it’s hard for them to envision becoming the donor themselves,” Dr. Thornton said. “We’re trying to create a bridge that makes it easier for those people to cross over.”

Bob Aronson of bobsnewheart is a 2007 heart transplant recipient, the founder of Facebook’s 1800 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.